This day-long seminar starts with a dispatch call of this scenario occurring and from this point forward, participants are invited to literally guide this patient from his initial treatment at the scene through the first 24 hours of his care in the emergency department, operative suites and intensive care unit. How much fluid should the patient receive in the first hour? What laboratory and radiological exams should be ordered? What ventilator settings would be appropriate? These, as well as numerous other decisions, are driven by participants who vote anonymously using their smart phones. The results of the votes are immediately displayed on the screen and the case study moves forward based on the majority vote. Ultimately, the outcome of the patient relies on the decisions of the audience. Participants will learn in real time how the care-decisions they make influence the trauma patient.

8:15 am - 9:30 am:

Course 400: GENERAL SESSION -- Crime Scenes -- FBI Special Agent

Sometimes EMS at a crime scene is not considered a resource for investigators...another set of eyes and experiences that can provide insight and context to what may be presented. What I hope to leave the group with is how the crime scene investigation (including WMD) has to occur (for legal purposes to hold up in court), how a crew can help, how a crew can hurt...and of course safety and security.

Traumatic brain injury (TBI) accounts for over 30% of all traumatic deaths in the United States. Regardless of medical advancements in treating TBI, the all- cause mortality for TBI remains high. Survival and quality of life depends on overall severity, location of injury and secondary brain injuries. Pre-Hospital providers are tasked with managing these challenging patients, with the ultimate focus on overall stabilization, with airway management, oxygenation, ventilation, and perfusion guiding our care. Secondary TBI is the silent killer, with one episode of hypoxia or hypotension increasing mortality by 50% respectively. In this talk we will use case based teaching, CT scans, pictures and lab values to identify and diagnose different TBI presentations, with a focus on discussing the dreaded Hypoxia, Hypotension and Hypercarbia. We will introduce H-H-H therapy that guides our care and helps prevent the “Silent Killers of TBI, with Hypertension, Hypervolemia and Hemodilution as our ultimate guide to goal directed therapy. Come join us for this case based talk on all things TBI and the impactful care that’s essential for positive outcomes.

My chest hurts just thinking about chest pain calls. Once dispatched you begin dancing to the sound of a broken heart and the clock is ticking, you need to decide where to go, what to do and how fast to get it all done. Cardiac calls present to us in a variety of ways and in many cases, they disguise themselves behind other illnesses or injuries. More and more we must evaluate all the patient complaints and try to fit them into one algorithm or protocol. What if you can’t fit them in? What if you need to fit the call into more than one protocol or algorithm? Join Kirk for a heart wrenching session that explores the common cardiac calls and how to deal with them in and out of the box.

As an industry we’ve seen huge advancements in trauma care in the past 10 years, however trauma is still one of the leading causes of death in the world. Unfortunately, secondary disease processes often kill many individuals that otherwise may have survived the initial traumatic event. The trauma triad of death is a significant issue still for many patients despite massive advancements in care and research. Why? Hypothermia!
Even mild hypothermia plays a major role in our coagulation processes. We as an industry do a horrible job with
temperature regulation. We’ve learned many lessons from resent military conflicts, with the high potential for hypothermia in military patients, despite ambient temperatures >100- 120 degrees Fahrenheit in Iraq. The lethal trauma triad is a potentially preventable disease process that starts with hypothermia, and then encompasses acidosis and coagulopathies based on other resuscitation factors. We will dissect preventable treatment options; look at the pathophysiology associated with the disease and dive into current research that looks at how we can be better in our treatment choices.

To often we enter scenes and say the words “My Scene Is Safe” just like we learned in EMT, AEMT and Paramedic class; only to find out later that that we have walked into the wrong situation at the wrong time. The goal of all public safety providers is to not just provide a service, but to make it home to our loved ones. In this session we will review the warning signs to look for while enroute to the call, upon arrival and once you are on scene.

These warning signs can make the difference between your life and your death. Through case studies and call reviews we will go through the mental checklist that we need to use to stay safe on the job and get home to our families. Join Kirk on the journey of learning why entering the scene with wide open eyes is imperative to your survival in a trying environment. Of course Kirk will tell a few personal stories of getting in deeper than he should have and getting shot while on a call. Kirk’s unique brand of humor, candor and story telling promises to keep you on the edge of your seat and to help you get home to your family after your shift.

Mechanical ventilation in the HEMS and Critical Care environments are now a standard of care for all intubated patients. Recent published studies have shown that new resuscitation strategies for mechanically ventilated trauma patients in low perfusion states needs to be looked at further; due to the potential secondary adverse effects associated with positive pressure ventilation and the increased intrathoracic pressures seen with
ventilation models. It’s evident that this has potential effects on venous return and cardiac output in already decompensating hemodynamically unstable trauma patients. Based on this physiology, patients have a huge potential for further decompensation, including profound shock and possible cardiac arrest. In this discussion we will look at new ventilation strategies for low-flow perfusion states using high tidal volumes and low rates in the attempt to reduce dead space ventilation and intrathoracic pressures.

Too often we get tunnel vision and miss the signs and symptoms we are trained to find. During this session, we will evaluate pediatric critical calls and what could have changed the outcome of these calls. What is critical thinking and how can I use it to better my patient outcomes? Grab your TOPHAT and join Kirk for a session filled with videos and case histories to help improve your Critical Thinking Skills.

Burn Injury assessment and treatment is continually advancing and continuing education on how to recognize and classify a burn injury as well as understanding the initial treatment options in the field and what will happen after the patient arrives to a specialty center is important in order to increase the patients success in recovery from thermal injuries. In this session we will look at the classification system of burn injuries and the field management of burns as well as the advances that have been implemented in the last several years including microsurgery and energy based treatments for scarring.